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Biomedical subjects

L Burrows

Publications and source records attributed to L Burrows.

At least 55 records · Page 3Linked to original sources
PubMed1993

A randomized double-blind study of fluoxetine versus placebo in the treatment of dysthymia.

OBJECTIVE: The purpose of this study was to assess the efficacy of fluoxetine, a selective serotonergic antidepressant, in the treatment of dysthymia. METHOD: Thirty-five patients who met criteria for dysthymia, but not major depression, began randomized, double-blind 8-week trials of fluoxetine or placebo. RESULTS: Of 32 patients who completed the study, 10 (62.5%) of the 16 patients given fluoxetine and three (18.8%) of the 16 given placebo responded to treatment. Response was defined as 1) 50% or greater decrease in Hamilton Rating Scale for Depression score and 2) a score of 1 or 2 on the Clinical Global Impression (CGI) improvement subscale. Fluoxetine subjects showed significantly greater improvement at week 8 than placebo subjects on the Hamilton depression and CGI scales, but not on the Hopkins Symptom Check-list (58-item) or the Cornell Dysthymia Rating Scale. CONCLUSIONS: When compared to placebo, fluoxetine showed short-term effectiveness in treating dysthymic symptoms.

Adult↗
PubMed1992

Mt. St. Anonymous; the adolescent living-related donor.

Seventeen-year-old David is a perfect organ match for his younger brother, Ken, who has kidney failure. David understands that the procedure presents some risk for him and that after surgery he may no longer be able to continue playing football. His idols all have been football players and he now plays on his high school's team. Nevertheless, he wants to donate a kidney to his brother and agrees to being a donor as soon as the option is mentioned. He never displays any ambivalence and says, "I want to donate my kidney because then I'll be a hero to my family." This close family--of two parents and five older siblings--strongly supports the seventeen-year-old's decision, especially after an older brother, who was also a perfect organ match, is found medically (anatomically) unsuitable. The parents and two of the older siblings could still be medically acceptable donors: their organs are likely to be better grafts (one haplotype matches) than a non-related cadaveric kidney would be, but less compatible than the perfect organ match (haploidentical) that could be provided by David, the adolescent brother. Studies have shown that in the short run there is little difference in the survivability of organs from different classes of donors. After several years, however, there is a significant difference with perfectly matched kidneys being much less prone to rejection than the less ideally matched organs.

Adolescent↗
PubMed1992

Organ perfusion by dynamic scintigraphy convection-diffusion tracer kinetics in a phantom.

Dynamic scintigraphy is used widely to evaluate qualitatively the perfusion of an organ. Attempts to quantify blood flow to an organ by means of scintigraphic imaging modalities have often employed assumptions that lead to oversimplifying the physiology of the tracer kinetics. We used a mathematical formalism described by W. Perl and F. P. Chinard (Circ. Res. 22: 273-298, 1968), the convection-diffusion tracer kinetics, model, for parameter evaluation of flow (F) and volume of distribution (V). This modeling methodology was evaluated using a circulatory phantom with absolute flow measured independently by flowmeter. In a series of 22 phantom experiments with F/V < 0.32 s-1, there was a strong correlation between F and flow probe measurement [r = 0.97; slope = 1.08 +/- 0.06 (SE)]. The theoretical analysis comparing this approach with classical tracer kinetics methods explains both the satisfactory results for F/V using mean transit time and the systematic overestimation of F/V using decay constant methods.

Animals↗
PubMed1991

The simultaneous measurement of glomerular filtration rate (GFR) and renal plasma flow (RPF) following renal transplantation by use of functional imaging.

A new method for evaluating renal function using dynamic scintigraphy and deconvolution is described; functional images can be created from the data to quantitate kidney function. Our data are indicating that GFR measurements obtained by this method do not differ from those obtained by classical renal clearance methods. As was expected measurements of renal plasma flow exceed the values of PAH clearance. Additional studies to determine extraction ratios must be done along with direct flow meter measurements.

Animals↗
PubMed1990

Follow-up of cyclosporine-treated pediatric renal allograft recipients after cessation of prednisone.

We attempted cessation of prednisone therapy in 16 pediatric renal allograft recipients who were between the ages of 3 1/2 and 16 years at the time of transplantation. Fourteen had primary grafts and 2 had second grafts. Nine had cadaver and 7 had living-related donor grafts. At the time of cessation of prednisone, cyclosporine was the only other immunosuppressive therapy for 15 of the patients and 1 patient was receiving CsA and azathioprine. All the patients had stable serum creatinines at the time prednisone was stopped, between 7 months and 5 years posttransplantation. Seven patients have had no episodes of rejection, continuing to receive CsA as their only immunosuppressive therapy and have stable renal function between 16 months and 3 1/2 years (mean: 2 years) after stopping prednisone. Stopping the small maintenance dose of prednisone resulted in improved growth in patients whose epiphyses were not fused. They improved their weight:height ratios and lost their cushingoid appearance. Serum cholesterol levels declined significantly. Patients who required antihypertensive drugs to control their blood pressure while receiving prednisone required fewer or no drugs when off prednisone. Nine patients had acute rejection episodes and were put back on maintenance prednisone following a 3-day steroid pulse. All these patients had a prompt improvement in renal function following the steroid pulse. However, only 3 stabilized function at preprotocol baseline Scr. Four currently have functioning grafts with Scr greater than the preprotocol Scr. Two patients have returned to dialysis. Although stopping steroids is a worthy goal in pediatric renal allograft recipients, we cannot recommend this strategy as routine management because of the 56% rate of acute rejection episodes in the patients who had prednisone withdrawn.

Adolescent↗
PubMed1989

Clinical trials of a new polytetrafluoroethylene-silicone graft.

A self-sealing polytetrafluoroethelene (PTFE)-silicone graft designed to be used early after implantation was placed in 30 end-stage renal disease patients. Thirty-five conventional PTFE grafts were used in the control group. All patients were followed for 1 year. In the PTFE-silicone graft group, median time for first use was 1 day after implantation. Conventional PTFE grafts were first used 2 to 4 weeks after implantation. Early punctures of the PTFE-silicone grafts (first 10 sessions), although more difficult to perform than late punctures, were not more difficult than punctures of conventional PTFE grafts. Late punctures in PTFE-silicone grafts were easier than conventional PTFE graft punctures. Bleeding after needle removal was significantly decreased after early and late punctures of PTFE-silicone grafts compared with conventional PTFE grafts (p less than 0.001). The PTFE-silicone graft can be used immediately after implantation, sparing patients additional access procedures for short-term dialysis. This results in less morbidity, decreased bleeding complications, shorter hospital stay, and a significant reduction in expenses.

Blood Vessel Prosthesis↗
PubMed1989

Hydroxylamine dilates resistance blood vessels of the perfused rat kidney and mesentery.

Hydroxylamine (ED50 values, 47 +/- 8.9 nmol and 320 +/- 39 nmol) dilates resistance arterioles of the perfused noradrenaline-preconstricted rat kidney and mesentery. In this respect hydroxylamine was approximately 63x and 320x less potent than acetylcholine (ACh) and 15x and 128x less potent than nitroprusside in the two perfused organs studied. The vasodilator effect of hydroxylamine (unlike that of ACh) was unaffected by CHAPS de-endothelialization suggesting that its effect is independent of endothelium-derived relaxing factor (EDRF).

Acetylcholine↗
PubMed1989

Inhibition of PAF-induced eosinophil accumulation in pulmonary airways of guinea pigs by anti-asthma drugs.

Intraperitoneal (i.p.) injection of platelet activating factor (PAF) in guinea pigs caused a dose-related increase in the number of eosinophils recovered from bronchoalveolar lavage fluid (BALF). The prevalence of eosinophils in BALF had significantly increased within 1 hr of i.p. injection of PAF (10 micrograms/animal) and was maximal after 24 hr. Subcutaneous osmotic mini-pumps were used to administer drugs for 5 days prior to i.p. injection of PAF (10 micrograms/animal) and for the subsequent 24 hr. The percentage increase of eosinophils in BALF, due to PAF, was inhibited in animals treated with dexamethasone, aminophylline, cromoglycate, tranilast or ketotifen, but not in animals treated with oxatomide, azelastine, amlexanox, ibudilast or AA-861. These results suggest that inhibition of pulmonary eosinophilia may be a necessary property of prophylactic anti-asthma drugs and provide indirect evidence favoring a role for PAF in eosinophilia of asthma.

Animals↗
PubMed1988

Immunopharmacodynamic profiles in children with renal allografts receiving cyclosporine therapy.

Eleven renal transplant patients between the ages of 4 and 19 years, on a single daily oral dose of cyclosporine (CsA) and either a low oral dose or no dose of prednisone, had venous blood drawn at periodic intervals throughout a 24-hour period. CsA levels were measured by whole blood radioimmunoassay. All the patients had similar patterns of CsA pharmacokinetics with a single peak blood level at two to eight hours after the drug was given. Plasmas separated from the bloods at 37 degrees C were added to third party mixed lymphocyte reactions (MLR). The kinetics of suppression of the MLR by serial plasmas did not follow the CsA levels. Instead, we observed patterns of suppression similar to those that have been described in adults. Five patients had pattern I with two peaks of plasma-mediated MLR suppression, and had no rejection episodes. Two of the patients had pattern II with only one peak of MLR suppression, and both had episodes of acute rejection. One patient showed pattern III with a pleateau of MLR suppression, and has had no rejection episodes and no obvious CsA toxicity. Three patients showed pattern IV with a continuously low level of plasma-mediated MLR suppression throughout the day, and two of them have had severe rejection episodes. Immunopharmacodynamic profiling (IP) may prove to be useful in individualizing therapeutic regimens for patients with renal allografts treated with CsA.

Adolescent↗
PubMed1987

Increased recurrence rates in perioperatively transfused colorectal malignancy patients.

Blood transfusions have been shown to induce immunomodulative alterations in the transfusee such as changes in suppressor to helper T-cell ratio. They also have a beneficial antirejection effect in renal transplant recipients. To determine if blood transfusions play a role in tumor recurrence, the records of 177 transfused and 118 untransfused patients with Dukes stages B2, C1, or C2 operated on between June 1976 and July 1979 were examined. Ninety-five percent of untransfused patients were recurrence free at the end of 1 year compared to 86% of perioperatively transfused patients (P greater than .005), and this difference persisted for the 5 years of the study. Transfused patients in any of the pathological stages had lower recurrence-free rates in every postoperative year. Critical statistical analysis in this retrospective study indicates that the administration of blood is an important factor in the development of recurrence, and the increased incidence of recurrence is unrelated to the extent of operation or to the clinical need for transfusions before or during surgery.

Colonic Neoplasms↗
PubMed1986

Double-lumen, silicone rubber, indwelling venous catheters. A new modality for angioaccess.

This report presents our experience using double-lumen, silicone rubber, indwelling central venous catheters with a subcutaneous Dacron cuff as access for hemodialysis. Twenty-seven catheters were placed in 27 patients through venous cutdowns. A 10-cm subcutaneous tunnel was created leaving the Dacron cuff 2 cm from the external exit. Sixteen Raaf catheters (lumen diameter [LD], 1 mm), three double-lumen Hickman catheters (LD, 1.6 mm) and eight HemoCath catheters (LD, 2 mm) were used. The tip of the catheter was positioned fluoroscopically in either the superior vena cava or the right atrium. One hundred fifty-nine treatments were done with the Raaf catheters (mean blood flow [MBF], 188.1 +/- 26.4 mL/min); two of these catheters became obstructed and could not be used further. Three double-lumen Hickman catheters were used in 12 hemodialysis treatments (MBF, 216.3 +/- 27.1 mL/min). One hundred fifty-five treatments were done using the HemoCath catheters (MBF, 236.7 +/- 5.5 mL/min). The degree of recirculation of these catheters was 8.56% +/- 4.34%. The major advantages of this modality include simplicity of introduction, lack of serious complications, no sacrifice of major arteries, no need for venipuncture, and potential use in either short- or long-term hemodialysis.

Adult↗